21
Principles of selective spinal imaging Explore all intercostal arteries to be covered by the stent-graft and adjacent With multislice CT (16 bit +), using the same acquisition as that taken for imaging the aortic lesion With sequential catheterization only in case of a failure Classify according to the result

40
Personal results with EVAR Systematic ESA Only 66 TEVAR cases ( 612 EVAR cases in the same period ) One paraparesis in one hybrid one-stepped elephant trunk under hypothermic circulatory arrest No paraplegia

41
Conclusion Postoperative paraplegia remains a disaster for the patient and a medicolegal concern for surgeons and radiologists Given the low rates of paraplegia after DTA repair and the small number of patients in the series of TAA repair, efficiency of protective methods is difficult to demonstrate The availability of SSI using CT renders blind repair of DTA or TAA questionable